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Elephant EEHV History Form

Elephant History

for Elephant Endotheliotropic Herpesvirus (EEHV) Testing

Department of Pathology

Smithsonian National Zoo

3001 Connecticut Ave, NW

Washington, DC 20008

202-633-4252

FAX: 202 673-4660 
 

Please fill out this form when submitting samples to the lab for EEHV testing for the first time.   There is no charge for the testing, but we do ask for some information for our studies.  Please send this history with the samples and the "Request for EEHV Testing" form.  Use additional pages, if necessary. 
 

1.  Please list all elephants currently at your facility.  Please include name, ISIS number, sex, age, breeding history, and move history. 
 
 
 
 
 
 
 
 
 
 

2.  Have there been any EEHV cases at your facility?  When?  Which elephants had direct or indirect contact with the EEHV case?  Is there anything that you feel may have contributed to the case (for example, but not limited to: recent move, new source of stress on an elephant, elephant arrival that you think is the source of the EEHV, etc)? 
 
 
 
 
 

3.  Did any of your elephants have direct/indirect contact with a documented EEHV case prior to coming to your facility? 
 
 
 
 

4.  Have there been any unexplained illnesses in any herd member in the past?  What were the clinical findings? 
 
 
 
 
 

5.  What is the purpose for EEHV testing today (circle all that apply)? 

  1. concern about active EEHV illness (viremia)-whole blood PCR requested
  2. upcoming move-ELISA requested
  3. suspicious skin, oral or genital lesion-PCR requested
  4. curious about EEHV titer-either current titer or longitudinal study requested
 
 
 
 
 
 
 
 

6.  Name/title/email address/telephone number of person filling out history? 
 
 
 

7.  Institution Name/Address? 
 
 
 
 
 
 

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Yulee, FL 32097 USA

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